ABSTRACT
Background: The outbreak of novel coronavirus (COVID-19) has turned into a public health emergency of international concern. With no antiviral drugs nor vaccine, presence of carriers without obvious symptoms and varied clinical characteristics, the traditional public health measures are certainly less effective. The early signs of COVID-19 and epidemiological data are essential to strengthen the overwhelmed healthcare systems. Aim: To detect, assess and analyse the early signs of COVID-19 in Pakistan before the official reporting of cases in the country. Methods: The study uses the EpiWATCH observatory to extract data from 1 November 2019 to 1 April 2020. The trend of pneumonia of unknown origin cases in Pakistan was observed to assess if cases of COVID-19 could have been detected before the first official case was reported. A descriptive analysis of the obtained data was achieved on the basis of geographic and demographic features. Results: A total of 151 entries were included in the study. Before the identification of the first official case of COVID-19 in Pakistan, 54 reports of cases of pneumonia of unknown origin were recorded. After the first case of COVID-19 was reported, 97 reports of cases of COVID-19 were recorded. The study findings suggest that there were early signs of COVID-19 in Pakistan since the second week of January 2020, a month and a half prior to the first case being reported in the country. © 2021 The Author(s).
ABSTRACT
Coronaviruses are a class of enveloped RNA viruses that cause infections of the respiratory tract, characterized by fever, tiredness, dry cough, diarrhea, loss of smell or taste, chest pain and shortness of breath. Many patients with mysterious pneumonia were distinguished in December 2019 in Wuhan. The pneumonia of obscure origin was found to be ascribed to a novel coronavirus and described as novel coronavirus pneumonia (NCP). The Chinese authorities initially reported the wave of mysterious pneumonia on December 31st, 2019 and it was declared as an outbreak of international concern on January 30th, 2020. A systematic search of relevant research was conducted, and a total of 58 primary research articles were identified, analyzed, and debated to better understand the hematologic profile in COVID-19 (Coronavirus disease) infection and its clinical implications. All the findings in this article manifest a true impression of the current interpretation of hematological findings of the SARS-COV-2 disease. Pathophysiology of COVID-19 disease can be better interpreted by taking into consideration the hematologic parameters. Clinical implications of the hematologic profile of COVID-19 patients including cytokine storm, coagulation profile, and thrombophilic complications are under-recognized. Therefore, this review focuses on the coagulation profile, cytokine storm, and its treatment options. The role of pre-existing thrombophilia in COVID-19 patients and how it could result in the poor prognosis of the disease is also debated. The recent data suggests that hypercoagulability could be the potential cause of fatalities due to COVID-19. Potential effects of tocilizumab, metronidazole, and ulinastatin in suppressing cytokine storm may help to treat SARS-COV-2 infection. This review also highlights the significance of thrombophilia testing in SARS-CoV-2 patients depending on the clinical features and especially in pregnant women.